 |
|
Prevention of Hip Fractures by External Hip Protectors
A Randomized Controlled Trial
Natasja M. van Schoor, MSc;
Johannes H. Smit, PhD;
Jos W. R. Twisk, PhD;
Lex M. Bouter, PhD;
Paul Lips, MD, PhD
JAMA. 2003;289:1957-1962.
Context Several randomized controlled trials have been performed to examine the effectiveness of external hip protectors in reducing the incidence of hip fractures, but the results are controversial.
Objective To examine the effectiveness of hip protectors in reducing the incidence of hip fractures in an elderly high-risk population.
Design, Setting, and Participants Randomized controlled trial of elderly persons aged 70 years or older, who have low bone density, and are at high risk for falls. Participants lived in apartment houses for the elderly, homes for the elderly, and nursing homes in Amsterdam and surrounding areas in the Netherlands. They were enrolled in the study between March 1999 and March 2001; the mean follow-up was 69.6 weeks. Of the 830 persons who were screened, 561 persons were enrolled.
Intervention External hip protector. Both groups received written information on bone health and risk factors for falls.
Main Outcome Measure Time to first hip fracture. Survival analysis was used to include all participants for the time they participated.
Results In the intervention group, 18 hip fractures occurred vs 20 in the control group. Four hip fractures in the intervention group occurred while an individual was wearing a hip protector. At least 4 hip fractures in the intervention group occurred late at night or early in the morning. Both in univariate analysis (log-rank P = .86) and in multivariate analysis (hazard ratio [HR], 1.05; 95% confidence interval [CI], 0.55-2.03), no statistically significant difference between the intervention group and control group was found with regard to time to first hip fracture. In addition, the per protocol analysis in compliant participants did not show a statistically significant difference between the groups (HR, 0.77; 95% CI, 0.25-2.38).
Conclusion The hip protector studied was not effective in preventing hip fractures.
Author Affiliations: Institute for Research in Extramural Medicine (Drs Twisk, Bouter, and Lips and Ms van Schoor), Departments of Sociology and Social Gerontology (Dr Smit), Clinical Epidemiology and Biostatistics (Dr Twisk), and Endocrinology (Dr Lips), Vrije Universiteit Medical Center, Amsterdam, the Netherlands.
RELATED LETTERS
External Hip Protectors and Risk of Hip Fracture
Tatjana Bulat and Pat Quigley
JAMA. 2003;290(7):883.
EXTRACT
| FULL TEXT
External Hip Protectors and Risk of Hip Fracture
Lisa A. Honkanen
JAMA. 2003;290(7):883-884.
EXTRACT
| FULL TEXT
External Hip Protectors and Risk of Hip Fracture
Peter Cummings and Noel S. Weiss
JAMA. 2003;290(7):884.
EXTRACT
| FULL TEXT
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
The Hip Impact Protection Project: design and methods
Barton et al.
Clin Trials 2008;5:347-355.
ABSTRACT
Osteoporosis Medication Use in Nursing Home Patients With Fractures in 1 US State
Parikh et al.
Arch Intern Med 2008;168:1111-1115.
ABSTRACT
| FULL TEXT
Efficacy of a Hip Protector to Prevent Hip Fracture in Nursing Home Residents: The HIP PRO Randomized Controlled Trial
Kiel et al.
JAMA 2007;298:413-422.
ABSTRACT
| FULL TEXT
Increased Prevalence of Falls Among Elderly Individuals With Mental Health and Substance Abuse Conditions
Finkelstein et al.
AJGP 2007;15:611-619.
ABSTRACT
| FULL TEXT
Are hip protectors correctly positioned in use?
Minns et al.
Age Ageing 2007;36:140-144.
ABSTRACT
| FULL TEXT
Hip protectors to prevent femoral fracture
de Rooij
BMJ 2006;332:559-560.
FULL TEXT
Effectiveness of hip protectors for preventing hip fractures in elderly people: systematic review
Parker et al.
BMJ 2006;332:571-574.
ABSTRACT
| FULL TEXT
What's New in Orthopaedic Trauma
Cole and Bhandari
JBJS 2004;86:2782-2795.
FULL TEXT
Recommendations for Optimal Care of the Fragility Fracture Patient to Reduce the Risk of Future Fracture
Bouxsein et al.
J Am Acad Orthop Surg 2004;12:385-395.
ABSTRACT
| FULL TEXT
OTHER ARTICLES NOTED (25 Apr 2003 to 18 Jul 2003)
Evid. Based Nurs. 2003;6:e1-12.
FULL TEXT
External Hip Protectors and Risk of Hip Fracture
Bulat and Quigley
JAMA 2003;290:883-883.
FULL TEXT
External Hip Protectors and Risk of Hip Fracture
Cummings and Weiss
JAMA 2003;290:884-884.
FULL TEXT
External Hip Protectors and Risk of Hip Fracture
Honkanen
JAMA 2003;290:883-884.
FULL TEXT
Treatment of postmenopausal osteoporosis
Cranney
BMJ 2003;327:355-356.
FULL TEXT
Do hip protectors help prevent hip fractures?
Bhandari
CMAJ 2003;169:215-215.
FULL TEXT
Hip protectors are ineffective for preventing hip and pelvic fractures
BMJ 2003;327:0-0.
FULL TEXT
Hip Protectors Ineffective for Preventing Hip Fracture
JWatch Emergency Med. 2003;2003:8-8.
FULL TEXT
Hip Protectors Might Prevent Hip Fractures -- But Only If They're Used
JWatch General 2003;2003:4-4.
FULL TEXT
|
